Community Engagement Grants Application

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Applicant Information

Please provide applicant information for the Community Engagement Grants Program. When you're finished filling out this form, click the print button to print the form, sign the signature field, and scan or fax to: Ken.Marcellus@daytonohio.gov | 937-333-4281.

Neighborhood Organization*

Contact Name*

Application Date*

Application Date

Address*

Zip*

Email*

Phone (Day)*

Phone (Evening)

Event Information

Please provide information regarding the event.

Name of Event*

Date of Event*

Date of Event

Amount Requested*

Total Event Cost*

Set-up Time*

Set-up Time

Start Time*

Start Time

End Time

End Time

Name of Park / Facility / Street*

Location of Park / Facility / Street*

Estimated Attendance

Please provide the estimated number of adults, children, and City employees that will attend this event.

Adults*

Children*

City Employees*

Have you conducted this event before?*

Yes

No

If you chose yes, when?

Describe the Event*

How do you plan to your 50% cash or in-kind match?*

Describe how you plan to use the amount requested*

I have read, understand and agree to the following information*

Agree

1. This Grant application must be submitted to the Department of Planning and Community Development 30 days before the scheduled event.

2. All arrangements for City services needed for this event are to be made by the applicant.

3. All event checks will be issued 10 days prior to the scheduled event.

4. The attached Post Event Report form is required and must be returned to the Department of Planning and Community Development within 30 days after the scheduled event.

5. All Post Event Reports will be kept by the Department of Planning and Community Development and upon request will be forwarded to the Department of Finance or Office of Management and Budget for review.